Abstract
BackgroundChronic hepatitis C (HCV) disease can be complicated with comorbid conditions that may impact treatment eligibility and outcomes. The aim of the study was to systematically review comorbidities and symptoms in an HCV infected population, specifically assessing comorbidities associated with HCV anti-viral treatment and disease, as well as comparing comorbidities between an HCV infected and uninfected control population.MethodsThis was a retrospective cohort study within a United States medical claims database among patients with chronic HCV designed to estimate the two-year period prevalence of comorbidities. Patients with two HCV diagnosis codes, 24 months of continuous health insurance coverage, and full medical and pharmacy benefits were included.ResultsAmong a chronic HCV cohort of 7411 patients, at least one comorbid condition was seen in almost all patients (> 99%) during the study period. HCV-infected patients reported almost double the number of comorbidities compared to uninfected controls. Of the 25 most common comorbidities, the majority of the comorbidities (n = 22) were known to be associated with either HCV antiviral treatment or disease. The five most frequent comorbidities were liver disease [other] (37.5%), connective tissue disease (37.5%), abdominal pain (36.1%), upper respiratory infections (35.6%), and lower respiratory disease (33.7%). Three notable comorbidities not known to be associated with antiviral treatment or disease were benign neoplasms (24.3%), genitourinary symptoms & ill-defined conditions (14.8%), and viral infections (13.8%).ConclusionsThis US medically insured HCV population is highly comorbid. Effective strategies to manage these comorbidities are necessary to allow wider access to HCV treatment and reduce the future burden of HCV disease and its manifestations.
Highlights
Chronic hepatitis C (HCV) disease can be complicated with comorbid conditions that may impact treatment eligibility and outcomes
The objectives of this study were: (1) to systematically estimate the prevalence of the top 25 comorbidities in an Hepatitis C virus (HCV) population; (2) to compare whether these most common HCV comorbidities differ between receiving antiviral treatment during the study period; and (3) to compare whether these most common HCV comorbidities differ between an HCV infected and uninfected control population
HCV study population characteristics A total of 7411 chronic HCV patients were included in this analysis (Table 2)
Summary
Chronic hepatitis C (HCV) disease can be complicated with comorbid conditions that may impact treatment eligibility and outcomes. Complications of chronic HCV are projected to increase dramatically over the few decades [3], placing an ever greater burden on health systems of a disease where the annual health care costs are already estimated at over. The current standard-of-care for chronic HCV treatment is combination pegylated-interferon and ribavirin with the addition of boceprevir or teleprevir for genotype 1 patients only [6]. Antiviral treatment may exacerbate certain conditions such as those with anaemia, thrombocytopenia or leukopenia, which can further complicate treatment outcomes by increasing the number and severity of side-effects [9]. Many patients are excluded from treatment, or have treatment deferred or compromised because of their comorbid conditions
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